Provider Demographics
NPI:1366255101
Name:FISHER, MADISON JEAN (MS OTR/L)
Entity type:Individual
Prefix:MS
First Name:MADISON
Middle Name:JEAN
Last Name:FISHER
Suffix:
Gender:F
Credentials:MS OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:246 FOREST PARK DR
Mailing Address - Street 2:
Mailing Address - City:CHALFONT
Mailing Address - State:PA
Mailing Address - Zip Code:18914-2142
Mailing Address - Country:US
Mailing Address - Phone:215-589-8625
Mailing Address - Fax:
Practice Address - Street 1:2100 QUAKER POINTE DR
Practice Address - Street 2:
Practice Address - City:QUAKERTOWN
Practice Address - State:PA
Practice Address - Zip Code:18951-2182
Practice Address - Country:US
Practice Address - Phone:215-804-1002
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-27
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC020375225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist